Cumulative Psychopathology and the Return-to-Sport Gap in Non-Elite Athletes: A Narrative Review of Injury vs. Forced Detraining

Abstract

Background: Regular physical activity acts as a physiological buffer for non-elite athletes, mediating emotional regulation. However, training continuity is frequently disrupted by individual traumatic musculoskeletal injuries or forced detraining (e.g., lockdowns). The differential mental health impact of these breaks in non-elite populations remains underexplored.

Aim: This narrative review aims to analyse the differential psychological impact of injury-induced versus forced detraining, and evaluate additional factors associated with training cessation in recreational athletes.

Material and methods: A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar databases for studies published between 1993 and early 2026. The review focuses on recreational athletes defined as individuals training regularly (>4 hours/week) without professional income.

Results: The reviewed literature reveals a consistent "return-to-sport gap" following injuries, where psychological barriers - primarily kinesiophobia and identity foreclosure - significantly hinder competitive return despite full physical recovery. In contrast, forced detraining events trigger collective acute crises characterized by widespread depressive symptoms, severe lifestyle and routine disruptions, and loss of motivation across the athletic population. Across both contexts, sidelined athletes exhibit high vulnerability to maladaptive coping, though targeted social support emerges as a universal mediator facilitating Post-Traumatic Growth.

Conclusions: The mental health impact of training cessation is mediated by the etiology of the break and the athlete’s cognitive appraisal. Clinicians must address not only the physical rehabilitation but also the potential for eating disorders, substance use, and identity crisis in sidelined amateurs.